Reclaiming Independence: Discovering the Lost Duties of Leadership
Chapter 8 – Healthcare
There is likely no better example of the ridiculousness in our socio-economic system than the totality of American healthcare. It’s a cycle involving insurance companies designed to produce shareholder value selling cost protection, pharmaceutical companies driven by shareholder profits cutting corners and hiking prices, and hospitals playing along with both out of their own financial interests, all of them feeding the politicians to keep the rules favorable to the cycle. The result of this is sick patients, dissatisfied with the care they receive and oftentimes feeling worse than before they sought treatment.
They sit quietly in waiting rooms long past their scheduled appointments that took months to arrive and wait even longer in the event it’s an emergency. Once they’ve finally been acknowledged, they’ll spend very little time in the presence of a doctor or nurse but still have a long wait before the visit is over. In the event of an admission, a patient might even be returned to the waiting room while they look for a bed upstairs and deal with another patient, spending their initial hours of admittance back in the ER waiting room. And once they’ve found a bed, that doesn’t mean it’ll get any better. In their room, they’ll probably have a nurse with too little experience caring for a number of patients beyond their reasonable capabilities. These healthcare workers will struggle to maintain their composure as they scurry through their halls of duty lacking both sufficient doctoral oversight and apt technical support. The access to a doctor isn’t any better either, as they’re availed to a patient for only moments each day, creating gaps in treatment that often stretch recovery timelines and extend hospital stays needlessly.
However, the American healthcare system is excellent at providing immediate life-saving treatment, so for the few of you who receive proper care, you will also be left with a financial obligation so insurmountable that it will remain with you for the rest of your life. It seems to me that in an industry where, literally, every participant has pledged a devotion to care for a person in need, it’s absurd how far they all let it drift from that.
Our nation spent $4.3 trillion on healthcare in 2021, averaging out to almost $13,000 per person, close to $4,000 more than any other country spends; yet, by most metrics, our healthcare system doesn’t even rank among the top ten in the world. This couldn’t be possible without the involvement of fraud, waste, and abuse; and it’s frustrating to watch a divided country argue over universal healthcare when we haven’t even been able to provide selective healthcare effectively. At the cost of over $4 trillion each year, it’s abundantly clear we have the resources to build an efficient healthcare system, the only question is whether we’re willing to come together as a nation to have the discussions that define the role of healthcare in our society.
It seems like with most divisive issues in America, our options for the future of healthcare are binary. In the public debate, our first option is to leave it into the hands of the private industry and allow the broken system we have to continue unabated. But the alternative is to give our broken government the power to collect trillions more in taxes than they already do, and trust in an already dysfunctional system to somehow remove dysfunction from healthcare. It’s safe to say, neither of the positions held by those paid to create divide are promising. But again, like with most divisive issues in America, our best approach to finding solutions is, first, finding leadership willing to discover what’s best for those they serve and not just what’s best for those who paid for them to secure the power. Only then will we start having discussions beyond what results in a binary choice between bad ideas.
We need to discuss the role any government has regarding healthcare. While some may argue that private enterprise will create the most efficiencies, something I might agree with in a truly capitalist society, others will have historical evidence of a broken system that justifies seeking out something new. Politicians, of course, use these arguments to create the illusion of progress while inciting further divide, establishing policies only good for business but detrimental to the quality of care. For example, COVID aside, how long has Obamacare been around, yet how many people remain uninsured and why have costs continue to increase? Barack Obama was literally elected on the promise of change, most notably change to our healthcare system, but did things get better or worse since then? Just like I can use my own experience to decide, each American can as well.
Both my experience and personal feelings about the healthcare industry run deep. In addition to the numerous surgeries and hospitalizations from injuries to my leg, back, hips, abdomen, and chest while in the military, my four-and-a-half-year-old son, Jacob, has been on life support since he was born, fully dependent on a daily injection of fluids, nutrients and lipids that are pumped through an IV line running directly to his heart. Those fluids alone cost over $11,000 per week; more than a half-million dollars per year, and if Jacob goes a single day without them, he will surely die. Further, the IV line to his heart is so delicate that it requires Jacob to have a nurse with him at all times to ensure its veracity, costing close to $400,000 a year. And none of this takes into the consideration the costs associated with the bloodwork he has weekly, other medications like iron infusions, specialty doctor visits and testing, any of the thirty or forty hospital stays he’s had, helicopter and ambulance rides he’s been on, operations, or the warehouse of medical supplies we need at home to properly care for him.
I am far from blind to the facts behind Jacob’s survival, such as the fact that he lives in both a place in history and a location on the globe where the resources for his survival are even possible, or that my military retirement was accompanied with an insurance plan that makes it all affordable. But I’m also not blind to the facts behind the differences between our situation and that of most Americans, such as the level of care and urgency at which a patient as rare as Jacob receives to that of the traditional patient, or the financial coverage almost all Americans will never have the privilege to obtain. That dual perspective is what’s provided me with the vision of how things could be if we just got down to making them happen.
I believe it’s possible to recreate our healthcare system to become one far surpassing the quality of healthcare anywhere in the world, maybe even for as little as 80% the cost we spend today. I believe healthcare can be rebuilt in a sustainably viable manner that combines the efforts of unified healthcare workers, motivated by renewed capitalistic principles, with a government willing to guide policies which remove profit-seeking objectives that decrease both quality and efficiencies within the system. Let’s start having the right discussions to make that happen.
For instance, determining whether healthcare is a universal right requires a discussion as to what we collectively deem to be the minimum acceptable standard of living in our society. Much like with the creation of Social Security, it should be determined that we collectively acknowledge our progress as a nation compels us to raise standards which we deem minimally acceptable for our national brethren, because it is this determination alone that will drive the justifications to declare healthcare a right. While I believe we indeed have progressed as a nation to justify universal healthcare, I also believe that we have nothing close to the leadership required to implement an efficient program that meets the healthcare needs of America. That must be our first objective to overcome if we are to achieve any change at all, in healthcare or elsewhere.
But in the event our nation rises from the void of darkness that decades of inadequate leadership have sunken us into, I imagine a world where local and state governments determine the medical needs of their citizens and work with owner-operated medical groups to operate the hospitals and clinics they’ve deemed compulsory to those needs. We should have a public debate of whether or not we’ve reached such heights as a society that healthcare should be a bare minimum right. But in the event we come to a national consensus, I believe there are ways for federal, state, and local governments to work together providing the universal framework that administers quality healthcare to all citizens. Similar to how the federal government could use education funds to build infrastructure that supports an education system for the 21st century, we could use the trillions we spend on healthcare in achieving a parallel infrastructure effort in the healthcare sector.
I envision a world where the resources to provide healthcare are combined in a way that costs less but provides more. And more than facilitating the needed infrastructure, I envision a federal government willing to subsidize the efforts of new pharmaceutical companies derived from an employee-equitized spirit. I can see a government filled with leaders taking the steps to restructure the medical research grant funding process. With that development, I see them creating more openness and preventing systemic oppression of data inconvenient to the beneficiaries of the cycle. I envision a world where we can rely on the advice of medical professionals again, because while capitalism is our main strength, greed in medicine would be replaced by individual participants relying on the medical advice they give as their ultimate value and means of personal success.
And I see a world where we will look back on those who misled us with collective scorn. From AIDS to COVID, Anthony Fauci has deceived the American public for decades exclusively to the benefit of himself and those reaping the financial gains from the federal research grant process. He is not someone we should be listening to or trusting, yet he was our government’s highest paid employee and led us through a pandemic he is the root source of. Those on the forefront of medical advancements are worthy of proper funding, but the moment greed and personal ambition overtake the objectives medical professionals pledge themselves to is the moment the People must intervene to demand change. He is the most shining example we have today.
In a future where the People have reclaimed America from the corporate tyrants in control today, I see a new way of doing things. Exactly what those new things are is something I don’t have a complete answer for, I can only attempt to steer a conversation into the direction for great minds to convene on and find solutions. I do believe that under the right leadership, and with the right corporate structures, our governments would be best suited to collect revenues needed to fund medical establishments. I also believe that a federal effort in conjunction with all fifty states could streamline many of the financial processes that create excessive administrative overhead costs to begin with. And I believe hospitals and clinics full of employees whose financial success derives directly from the level of care they provide would increase both the speed and quality of care Americans receive. We have enough money, resources, and able-bodied, talented healthcare professionals in America to build a healthcare system far superior to what we have today, we simply need to pave the way for it to happen.
Maybe this new, magical, federal government could treat new hospitals the same as they treat professional athletes. Maybe the Department of Commerce and HHS could create loan and other business programs to kickstart new medical establishment formations which operate under local or statewide contracts to provide medical care, free of charge. Considering the $1.7 trillion in federal mandatory spending that accounts for the overall $4-plus-trillion spent overall annually, the federal government could be doing more to assure the money it spends creates quality and efficiency rather than being thrown down the drain on administrative costs and inflationary adjustments required to support shareholder profits.
We could do more to stop drug manufacturers from price gouging Americans while offering the exact same drugs at a fraction of the cost internationally. Upon determining healthcare as a right, we would inherently recognize the immorality of insurance companies’ ability to control the cost associated to that right out of their own profit-seeking desires. And much like we did with the formation of the Social Security Administration, we could recognize the need for our government to institute the economic stability required to support healthcare so health insurance can die the death it needs to die for the rest of us to survive. Upon the implementation of these new initiatives, the healthcare system might become restored as a public good no longer burdened by the need of financial gain, but rather advanced by motivations derived from the desire of our healthcare professionals to provide the best care possible.
There is also more that can be done on an educational front. In the event our federal government redirected the money that ends up in the hands of universities into building a free national university available to all, we would surely have more doctors with less burdensome debt, requiring less salary to achieve personal success, opening opportunities for decreasing healthcare costs along the way. And in the fairy tale ending that we have a national university, employment programs could sprout up that offer placement with students upon successful completion of their degrees, ensuring labor participation demands are being met and adequate healthcare is being universally provided. Furthermore, if quality healthcare was available to us all, there would be no need for veteran or other healthcare systems, as they could all be combined into a single, effective system. Combining such systems removes administrative redundancies and offers veterans freedom from dependence on the also broken VA healthcare network.
The bottom line is that four trillion dollars is an ungodly amount of money, an amount only two other countries in the world could generate throughout their entire economies. It’s such an astronomical figure that we should all be embarrassed and ashamed of how little it provides, and all be willing to work together finding ways to spend it more appropriately, if, for no one’s benefit, than at least our own. Let’s stop attacking ideas surrounding universal healthcare as purely socialist while hypocritically claiming our system is purely capitalist, and instead invite the idea both claims are wrong to bring us a new perspective that leads to new systems built upon the foundations of freedom, independence, and liberty.
Like all my thoughts, these are only that, thoughts. I believe one of the main problems we have as a nation in general is that we’re living off old systems that were once designed with the future in mind but now exist to support the needs of the past. It’s time we start rethinking how we’ve got everything set up, healthcare any beyond. It’s time we start having conversations which bring forth new ideas that support the needs of tomorrow. I don’t have any answers, only ideas to share. But if you believe four trillion dollars per year is not enough to provide every American with the best healthcare possible, then you have no idea how much money that actually is. My argument is that we could probably do it for a lot less, so long as enough leaders in this country are guiding the ship in a direction benefiting the American People. I believe we have within us what it takes to bring about this historic change that’s long overdue, and I remain hopeful we rise to this occasion.
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